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Pediatrician pushing formula to clear up jaundice

My daughter is 4 days old. She is at higher risk of jaundice because my blood type is positive and hers is negative. When we got discharged from the hospital, her bilirubin level was 6.6, well below the 10.4 would have required bililights. They wanted me to take her to the pediatrician today to follow up on her bilirubin levels.
So, the pediatrician said that she looked a little yellow to her. And since she hasn't pooped since over a day ago, I need to replace two feedings with formula for three days to help her poop. This diagnosis was made before any blood tests of actual bilirubin levels. The pediatrician handed me a ton of free formula samples of various types she had lying around. She sent me to the lab to get my daughter's blood tested and is supposed to call me with the results later this afternoon.
The whole thing seems wrong to me! I am feeding on demand every 2-3 hours, sometimes more frequently. She had plenty of wet diapers. My milk only just truly came in late yesterday. She is gaining weight. I don't think one day is enough to base a pooping pattern on. I do not want to give her any formula!

Re: Pediatrician pushing formula to clear up jaundice

Personally I wouldn't give the formula. Let your milk do its work. And if things still do not improve in a few more days, you can always pump and supplement with your own milk. Did the ped have you schedule a followup?

Re: Pediatrician pushing formula to clear up jaundice

Not sure I like the pediatrician's advice. Formula doesn't make babies poop any better than breastmilk does- in fact, breastfed babies tend to poop much more often than formula-fed ones. And as long as the baby's bilirubin is not in the dangerous range, there is no need for supplemental feedings.

Where it gets tricky is when a lack of poop indicates that a breastfed baby isn't eating enough. This is not uncommon with jaundiced babies because jaundice can make a baby quite sleepy.

Did the results come back from the lab yet? And what were they? If supplemental feedings are necessary, we'll walk you through them!

Re: Pediatrician pushing formula to clear up jaundice

Formula is a medical intervention for the breastfed baby. Even when it is needed, there are potential consequences that need to be considered and discussed between parent and pediatrician. If you disagree with this suggested medical intervention, can you get a second opinion? Or ask if it would be ok to make an effort to increase nursing frequency, instead? Or maybe to pump and give baby your expressed milk as a supplement? I am not saying either is needed, I have no idea. But generally when a baby requires supplements it is because they are not getting enough breastmilk, so in most cases the first logical action would be to see if there is a way to increase breastmilk into baby.
If formula is needed because baby is not getting ENOUGH, then it is a supplement and should not be REPLACING nursing but be given in addition to normal nursing frequency, I would think. So I agree it seems odd to suggest that nursing session be REPLACED by formula.

Re: Pediatrician pushing formula to clear up jaundice

That is pretty terrible advice. Nurse as much as you can, and if I were you I would start looking for a new doc. Handing out formula samples and giving anti-breastfeeding advice without even waiting for the lab results are huge red flags to me.

Re: Pediatrician pushing formula to clear up jaundice

Her level was 11.5, with 14.4 being the "treatment needed" level for her age. So, still below that. But the doc wanted to see us again this morning. So, we went and I told her that I did not intend to give my baby formula unless it was the absolute last resort. I explained to her that I had been making sure she gets more hindmilk by nursing from only one breast and/or pumping a little before feeding. Her stool have increased in frequency. The doctor told me it was my choice on how to feed my baby, but she still insists that somehow formula would "clear her bowels" and that she just doesn't want to have her end up in the hospital with suddenly spiked bilirubin levels. She sent me for another blood test. I am going to see if the other doctors at this practice are more breast-feeding knowledgable, otherwise I am going to find another doctor.

Re: Pediatrician pushing formula to clear up jaundice

Originally Posted by @llli*mshokie

The doctor told me it was my choice on how to feed my baby, but she still insists that somehow formula would "clear her bowels" and that she just doesn't want to have her end up in the hospital with suddenly spiked bilirubin levels.

I'm sorry, but this is just awful. Your doctor should not be threatening/coercing you in any way ESPECIALLY when what you are trying to avoid is feeding your baby a substandard artificial substance.

Re: Pediatrician pushing formula to clear up jaundice

My LO had jaundice while we were still in the hospital, and we got a lot of the "you don't want her to get worse and have to come back" talk. So we did what was asked -- they did the light box and blanket for almost a whole day. I felt so bad with my LO in there, only coming out every 2 hours to nurse (that was their rule, and I didn't really know any better, plus we hadn't figured out nursing success yet). But even my pediatricians (who are the "breastfeeding friendly," but not "breastfeeding knowledgeable" type) only asked that we give an ounce of formula since she wasn't nursing well just to help her poop more. So swapping a feed for formula seems extreme! They also told me we could sit in the sun a bit or even in front of a window (it was October and getting cold) and that would help some.

Mom to my sweet little "Pooper," born 10/12/11, and "Baby Brother," born 6/23/2014, and married to heavy metal husband. Working more than full-time, making healthy vegetarian meals for family, and trying to keep up with exercise routine.